Social Isolation Predicts Frequent Attendance in Primary Care

Cruwys, Tegan; Wakefield, Juliet R. H.; Sani, Fabio; Dingle, Genevieve A.; Jetten, Jolanda

doi:10.1093/abm/kax054

Cited by 53 publications

(44 citation statements)

References 53 publications

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“…Our patient survey allowed us to empirically examine these associations. Our results replicated previous findings showing the importance of group memberships for health service usage (eg, Cruwys et al 12), and we illustrate the predictive direction of this effect, with group memberships predicting increased community belonging, which predicts reduced loneliness. Moreover, these factors serially predict health service use, even when controlling for age, gender, relationship status and education.…”

Section: Discussionsupporting

confidence: 90%

“…Our qualitative analyses point to a consensus among GPs, SP staff and patients: loneliness and social isolation—key threats to patient health—can be addressed through SP. In line with research in the social cure tradition which has demonstrated a direct link between lack of social group connectedness and GP attendance,12 the absence of meaningful associative relationships is recognised by these health professionals to have detrimental health effects. Moreover, social isolation was perceived by GPs as being directly related to the frequency of inappropriate usage of primary care services by some patients and SP was recognised as a remedy for this.…”

Section: Discussionmentioning

confidence: 72%

“…Loneliness has also been linked to increased contact with primary care services especially among the elderly,10 11 with loneliness12 and associated mental-health concerns13 being increasingly common reasons for general practitioner (GP) visits. Multinational surveys, including the UK, show that around one-third of patients with depression/anxiety contact primary care,14 but fewer than one-third of these receive treatment 15.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The social cure of social prescribing: a mixed-methods study on the benefits of social connectedness on quality and effectiveness of care provision

et al. 2019

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ObjectivesThis study aimed to assess the degree to which the ‘social cure’ model of psychosocial health captures the understandings and experiences of healthcare staff and patients in a social prescribing (SP) pathway and the degree to which these psychosocial processes predict the effect of the pathway on healthcare usage.DesignMixed-methods: Study 1: semistructured interviews; study 2: longitudinal survey.SettingAn English SP pathway delivered between 2017 and 2019.ParticipantsStudy 1: general practitioners (GPs) (n=7), healthcare providers (n=9) and service users (n=19). Study 2: 630 patients engaging with SP pathway at a 4-month follow-up after initial referral assessment.InterventionChronically ill patients experiencing loneliness referred onto SP pathway and meeting with a health coach and/or link worker, with possible further referral to existing or newly created relevant third-sector groups.Main outcome measureStudy 1: health providers and users’ qualitative perspectives on the experience of the pathway and social determinants of health. Study 2: patients’ primary care usage.ResultsHealthcare providers recognised the importance of social factors in determining patient well-being, and reason for presentation at primary care. They viewed SP as a potentially effective solution to such problems. Patients valued the different social relationships they created through the SP pathway, including those with link workers, groups and community. Group memberships quantitatively predicted primary care usage, and this was mediated by increases in community belonging and reduced loneliness.ConclusionsMethodological triangulation offers robust conclusions that ‘social cure’ processes explain the efficacy of SP, which can reduce primary care usage through increasing social connectedness (group membership and community belonging) and reducing loneliness. Recommendations for integrating social cure processes into SP initiatives are discussed.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The social cure of social prescribing: a mixed-methods study on the benefits of social connectedness on quality and effectiveness of care provision

et al. 2019

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“…Other factors related to DSI such as social isolation, self‐esteem or falls are also discussed as underlying reasons for the association between DSI and HCU. For example, factors such as social isolation have been shown to be associated with increased HCU . However, we additionally adjusted for all of these factors (i.e., falls, self‐esteem, perceived autonomy and social isolation) in a robustness check (results not shown, but available upon request) and our results remained almost the same (for DSI with number of specialist visits as outcome measure, IRR = 1.16 [1.06–1.28], P < 0.01).…”

Section: Discussionmentioning

confidence: 77%

Dual sensory impairment and healthcare use: Findings from a nationally representative sample

Hajek

König

2020

Geriatrics Gerontology Int

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Aim Dual sensory impairment (DSI) is a common phenomenon in later life. However, only a few studies investigated whether DSI is associated with healthcare use. Therefore, our purpose was to determine whether DSI is associated with healthcare use among older adults. Methods Data were taken from the most recent sixth wave of the German Ageing Survey. When self‐reported hearing problems and visual impairment were both present, individuals were classified as dual sensory impaired. The frequency of general practitioner (GP) visits, frequency of specialist visits and hospitalization were used as outcome measures. Covariates (mainly based on self‐reports) were selected based on Andersen's behavioral model. In total, 5081 observations were in our analytical sample. Results Among individuals with DSI, mean ± SD number of GP visits was 4.4 ± 4.7, mean ± SD number of specialist visits was 3.7 ± 5.0, and 23.2% were hospitalized in the past 12 months. Among individuals without sensory impairment, mean ± SD number of GP visits was 3.0 ± 3.6, mean ± SD number of specialist visits was 2.4 ± 3.4, and 17% were hospitalized in the past 12 months. Negative binomial regressions revealed that the presence of DSI was associated with increased specialist visits (incidence rate ratio = 1.17 [95% confidence interval: 1.06–1.28]), whereas it was not associated with GP visits and hospitalization. Conclusions Even after adjusting for several covariates, individuals with DSI had higher specialist visits than individuals without DSI. As the presence of DSI is associated with an increased economic burden, efforts to prevent or delay DSI may be beneficial. Geriatr Gerontol Int ••; ••: ••–•• Geriatr Gerontol Int 2020; ••: ••–••.

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“…Increasing awareness about the importance of screening for (perceived) social isolation in daily practice may help to identify people who may be at high risk of cognitive decline. Indeed, previous studies have demonstrated that individuals with unmet social needs are more likely to be frequent users of health care services . The development of tailored interventions that include the enhancement of social participation and the maintenance of emotionally supportive relationships might contribute to cognitive decline prevention and risk reduction.…”

Section: Discussionmentioning

confidence: 99%

Are loneliness and social isolation associated with cognitive decline?

Lara

Caballero

Rico-Uribe

et al. 2019

Int J Geriat Psychiatry

268

169

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Objective This study aimed to examine the association of loneliness and social isolation on cognition over a 3‐year follow‐up period in middle‐ and older‐aged adults. Methods Data from a Spanish nationally representative sample were analyzed (n = 1691; aged 50 years or older). Loneliness, social isolation, and cognition (immediate recall, delayed recall, verbal fluency, forward digit span, backward digit span, and a composite cognitive score) were assessed both at baseline and at follow‐up. Adjusted generalized estimating equations models were performed. Results Loneliness was significantly associated with lower scores in the composite cognitive score, immediate and delayed recall, verbal fluency, and backward digit span (B = −0.14 to B = −3.16; P < .05) and with a more rapid decline from baseline to follow‐up in two out of six cognitive tests. Higher social isolation was associated with lower scores in the composite cognitive score, verbal fluency, and forward digit span (B = −0.06 to B = −0.85; P < .05). The effect of loneliness and social isolation on cognition remained significant after the exclusion of individuals with depression. Conclusions Both loneliness and social isolation are associated with decreased cognitive function over a 3‐year follow‐up period. The development of interventions that include the enhancement of social participation and the maintenance of emotionally supportive relationships might contribute to cognitive decline prevention and risk reduction.

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Social Isolation Predicts Frequent Attendance in Primary Care

Abstract: Unmet social needs among frequent attenders warrant closer consideration. Interventions that target social group connectedness show promise for reducing overutilization of primary care services.

Cited by 53 publications

References 53 publications

The social cure of social prescribing: a mixed-methods study on the benefits of social connectedness on quality and effectiveness of care provision

The social cure of social prescribing: a mixed-methods study on the benefits of social connectedness on quality and effectiveness of care provision

Dual sensory impairment and healthcare use: Findings from a nationally representative sample

Are loneliness and social isolation associated with cognitive decline?

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